A prospective Canadian gastroesophageal cancer database: What have we learned?

Autor:	Purich K; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh) kpurich@ualberta.ca., Skubleny D; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh)., Ghosh S; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh)., Bédard ELR; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh)., Stewart KC; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh)., Johnson ST; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh)., Haase E; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh)., McCall M; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh)., Schiller D; From the Department of Surgery, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Bédard, Stewart, Johnson, Haase, McCall, Schiller); the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (Purich, Skubleny, Ghosh, Bédard, Stewart, Johnson, Haase, McCall, Schiller); and the Department of Oncology, University of Alberta, Edmonton, Alta. (Ghosh).
Jazyk:	angličtina
Zdroj:	Canadian journal of surgery. Journal canadien de chirurgie [Can J Surg] 2023 Aug 08; Vol. 66 (4), pp. E422-E431. Date of Electronic Publication: 2023 Aug 08 (Print Publication: 2023).
DOI:	10.1503/cjs.005122
Abstrakt:	Background: Minimal literature exists on outcomes for Canadian patients with gastroesophageal adenocarcinoma (GEA). The objective of our study was to establish a prospective clinical database to evaluate demographic characteristics, presentation and outcomes of patients with GEA. Methods: Patients diagnosed with GEA were recruited from Jan. 30, 2017, to Aug. 30, 2020. Data collected included demographic characteristics, presentation, treatment and survival. A multivariable model for overall survival in patients treated with curative intent was created using sex, lymph node status, resection margin status, age and tumour location as variables. Results: A total of 122 patients with adenocarcinoma of the stomach or gastroesophageal junction were included. Median age was 65 years (interquartile range [IQR] 59-74), 70% of patients were male and 26% were born outside of Canada. Median follow-up time was 14.5 (IQR 8.0-31.0) months. Following staging computed tomography scanning, 88% of patients were deemed to have potentially resectable disease. Eighty-one (76%) received staging laparoscopy and 74 (61%) were treated with curativeintent surgery. Forty-six (62%) patients had nodal metastases. The median number of nodes harvested was 22 (IQR 18-30). The R0 resection margin rate was 82%. The 3-year overall survival for patients who received curative-intent treatment was 63% and 38% for all patients. On multivariable analysis, female sex (hazard ratio [HR] 3.88, p = 0.01), positive nodal status (HR 3.58, p = 0.02), positive margins (HR 3.11, p = 0.03) and tumour location (HR 3.00, p = 0.03) were associated with decreased overall survival. Conclusion: Many of the patients with GEA in this study presented with advanced disease, and only 61% were offered curative-intent surgery. A prospective multicentre national GEA database is now being established. Competing Interests: Competing interests: E. Bédard has received consulting fees from AstraZeneca and Hoffmann–La Roche. No other competing interests were declared. (© 2023 CMA Impact Inc. or its licensors.)
Databáze:	MEDLINE
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